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October 7, 2025

Podcast episode 34: John McDonough

Welcome to the Pioneers in Health podcast. In this podcast, we share inspiring stories of pioneering leaders from our nation and from your backyard who are working to improve health.

In episode 34, we interview John McDonough, professor of public health practice at the Harvard T.H. Chan School of Public Health. He served as a legislator for the Massachusetts House of Representatives from 1985 to 1997.

He discusses how the skills he learned being a community organizer helped him win his first race for the Massachusetts House of Representatives, in which he ran against an incumbent of 30 years.

“I looked at the challenge of running as an organizing challenge — a community organizing, a labor organizing, a political organizing — and so the challenge was to figure out how many votes I needed and then to build an organization that could deliver that number of votes,” John said.

“Accidentally, I got appointed to the Joint Committee on Healthcare in the legislature and fell head over heels in love with health policy — state, local and national,” John said.

He went on to serve in leadership positions for various health committees and played a role in helping shape significant health policy for the state, including reinventing its Medicaid program, which put the state on the pathway to what ultimately became universal coverage law in 2006.

He shares lessons he learned during his time as a legislator, as well as how his career took him in a variety of roles that continued to impact health policy.

When asked what gives him hope today, he said he is always hopeful — even during challenging times for health policy like today. He discussed the years that each party has dominated the U.S. House, Senate and presidency.

“There are waves, and there are ups and downs,” he said. “And one of the things that I noticed is that whatever period you’re in, whether things are going really well or things are going really poorly, you get this feeling — this sense like, ‘Oh my God, this is going to go on forever. It’s never going to end.’ And you’re always wrong. It’s always going to turn around, and so this, too, where we are right now, shall pass, and there will be important opportunities that emerge from it.”

He also discusses:

  • Creating the model for what nationally became the Children’s Health Insurance Program (CHIP) program
  • Efforts to achieve near-universal health coverage in Massachusetts
  • Working with Sen. Edward Kennedy to essentially use Massachusetts’ landmark health care reform legislation as the foundation for the Affordable Care Act
  • Important aspects of the Affordable Care Act, including the Health Insurance Marketplace
  • How the One Big Beautiful Bill Act, or HR1, will negatively impact state Medicaid programs and how voting to expand Medicaid in Kansas would help offset some of those funding losses; Kansas is one of only 10 states that has not expanded its Medicaid program as part of the ACA
  • Waste, fraud and abuse
  • Private equity and monopolization and how that can impact rural hospitals

And much more! Listen now, and learn more about how John is an innovative leader in health care and health care policy.


Listen now

Listen below or on any of your favorite podcast services. Like and subscribe to stay up-to-date with each new episode!

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Please see the Pioneers in Health page on our website for more information on our podcast series and links to other episodes.  

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